无张力阴道吊带术治疗女性压力性尿失禁

目的：探讨无张力阴道吊带术(TVT)治疗女性压力性尿失禁的初步疗效和手术安全性。方法：对20例经过临床和尿动力学检查诊断为压力性或混合性尿失禁的女性患者进行TVT手术治疗，并对手术效果和并发症进行初步的随访研究。结果：平均手术时间40min(25—100min)，平均术后住院3．2d(1—28d)。18例单纯性压力性尿失禁患者16例治愈，治愈率为88．89％(16／18)，另2例显效(11．1％)。2例混合性尿失禁患者中1例显效，另1例无效。术后发生尿潴留3例，2例作松解术，1例延长导尿管留置时间后缓解。发生局部血肿1例经保守治疗后康复。结论：TVT手术是一种治疗压力性尿失禁的安全有效的方法，具有手术简单、创伤小、并发症少、患者康复快等优点。

A primary results of tension-free vaginal tape for surgical treatment of female stress urinary incontinence

Purpose:To present the primary clinical results of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Methods:A prospective open study using a standardized protocol for pre and post operative evaluation. 20 cases consecutive women participated in the study. All suffered from genuine stress incontinence or mixed urinary incontinence. The mean age was 50.6 years. A prolene tape around mid-urethra was implanted via a minimal vaginal incision. The procedure is carried out under epidural anesthesia or local anesthesia.Results:Mean operation time was 40 minutes (range 25-100), mean postoperative stay duration was 3.2 days (range 1-28). 88.9 % of the women with genuine stress incontinence were cured and another 11.1% significantly improved. In the two mixed incontinence cases, 1 significantly improved and 1 failure. 3 cases had postoperative retention, 2 need surgical intervention, and 1 relieved after 3 weeks indwelling catheter. 1 case of hematoma observed and cured with conservative treatment. No defect in healing or rejection of the tape occurred. Conclusions:From the present study we can consider the tension free vaginal tape operation to be a safe and effective surgical procedure for the treatment of female urinary stress incontinence.